Nokea
You have just taken report for your shift and you are doing your initial assessment of your patients. One of your patients asks you if an error has been made in her medication. You know that an incident report was filed yesterday after a nurse inadvertently missed a scheduled dose of the patients antibiotic. Which of the following principles would apply if you give an accurate response?
- A. Veracity
- B. Confidentiality
- C. Respect
- D. Justice
Correct Answer: A
Rationale: The obligation to tell the truth and not deceive others is termed veracity. The other answers are incorrect because they are not obligations to tell the truth.
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The care team has deemed the occasional use of restraints necessary in the care of a patient with Alzheimers disease. What ethical violation is most often posed when using restraints in a long-term care setting?
- A. It limits the patients personal safety.
- B. It exacerbates the patients disease process.
- C. It threatens the patients autonomy.
- D. It is not normally legal.
Correct Answer: C
Rationale: Because safety risks are involved when using restraints on elderly confused patients, this is a common ethical problem, especially in long-term care settings. By definition, restraints limit the individuals autonomy. Restraints are not without risks, but they should not normally limit a patients safety. Restraints will not affect the course of the patients underlying disease process, though they may exacerbate confusion. The use of restraints is closely legislated, but they are not illegal.
A nurse has been using the nursing process as a framework for planning and providing patient care. What action would the nurse do during the evaluation phase of the nursing process?
- A. Have a patient provide input on the quality of care received.
- B. Remove a patients surgical staples on the scheduled postoperative day.
- C. Provide information on a follow-up appointment for a postoperative patient.
- D. Document a patients improved air entry with incentive spirometric use.
Correct Answer: D
Rationale: During the evaluation phase of the nursing process, the nurse determines the patients response to nursing interventions. An example of this is when the nurse documents whether the patients spirometry use has improved his or her condition. A patient does not do the evaluation. Removing staples and providing information on follow-up appointments are interventions, not evaluations.
A patient with migraines does not know whether she is receiving a placebo for pain management or the new drug that is undergoing clinical trials. Upon discussing the patients distress, it becomes evident to the nurse that the patient did not fully understand the informed consent document that she signed. Which ethical principle is most likely involved in this situation?
- A. Sanctity of life
- B. Confidentiality
- C. Veracity
- D. Fidelity
Correct Answer: C
Rationale: Telling the truth (veracity) is one of the basic principles of our culture. Three ethical dilemmas in clinical practice that can directly conflict with this principle are the use of placebos (nonactive substances used for treatment), not revealing a diagnosis to a patient, and revealing a diagnosis to persons other than the patient with the diagnosis. All involve the issue of trust, which is an essential element in the nursepatient relationship. Sanctity of life is the perspective that life is the highest good. Confidentiality deals with privacy of the patient. Fidelity is promise-keeping and the duty to be faithful to ones commitments.
An adult patient has requested a do not resuscitate (DNR) order in light of his recent diagnosis with late stage pancreatic cancer. The patients son and daughter-in-law are strongly opposed to the patients request. What is the primary responsibility of the nurse in this situation?
- A. Perform a slow code until a decision is made.
- B. Honor the request of the patient.
- C. Contact a social worker or mediator to intervene.
- D. Temporarily withhold nursing care until the physician talks to the family.
Correct Answer: B
Rationale: The nurse must honor the patients wishes and continue to provide required nursing care. Discussing the matter with the physician may lead to further communication with the family, during which the family may reconsider their decision. It is not normally appropriate for the nurse to seek the assistance of a social worker or mediator. A slow code is considered unethical.
A class of nursing students is in their first semester of nursing school. The instructor explains that one of the changes they will undergo while in nursing school is learning to think like a nurse. What is the most current model of this thinking process?
- A. Critical-thinking Model
- B. Nursing Process Model
- C. Clinical Judgment Model
- D. Active Practice Model
Correct Answer: C
Rationale: To depict the process of thinking like a nurse, Tanner (2006) developed a model known as the clinical judgment model.